Objective To evaluate the change about the function of pituitary thyroid axis and the role of human chorionic gonadotropin (hCG) on regulation of pituitary thyroid axis in pregnancy Methods The study was designed to provide longitudinal information of parameters of thyroid function and hCG in 74 healthy women during pregnancy and after delivery Serum free triiodothyronine (FT 3), free thyroxin (FT 4), TT 3, TT 4, hCG and thyroid hormone binding globulin (TBG) concentrations were measured with radioimmunoassary and serum TSH concentration with immunoradiometric assay Results (1) The FT 3 and FT 4 values below the reference range were 5 88% and 9 80%, respectively, in third trimester and after delivery, both were 38 10% The serum TSH level below the reference range was 31 25% in first trimester and supranormal were 11 90% after delivery The serum hCG level at all stages of pregnancy was higher than postpartum (2) The serum FT 3 level was significantly higher in first (4 37?0 78) pmol/L and second (4 75?0 90) pmol/L trimesters than postpartum (2 96?0 84) pmol/L, decreased in third trimester (3 94?0 75) pmol/L and the lowest level after delivery The serum FT 4 level was significantly higher in first (14 07?1 44) poml/L and second (12 86?0 84) pmol/L trimesters than postpartum (10 45?1 45) poml/L, decreased in third trimester (11 29?1 00) pmol/L and the lowest level after delivery (3) The serum TSH level was the lowest values in early pregnancy (0 88?0 83) mU/L, showed significant increase in second (1 86?1 04) mU/L and third (1 48?0 90) mU/L trimesters and reached maximal level after delivery (2 82?1 42) mU/L (4) The serum hCG level was the highest in early pregnancy (309 05?320 02) ?g/L, then significant decreased in second (69 11?19 18) ?g/L and third (86 25?44 60) ?g/L trimesters and was the lowest levels after delivery (29 92?20 91) ?g/L (5) A significant negative correlation between TSH and hCG levels and a significant positive correlation between hCG and FT 4 and TT 4/TBG were demonstrated Conclusions (1) hCG may be as role on regulation of pituitary thyroid axis during pregnancy and during certain time of postpartum (2) After delivery, part of women were transient hypothyroxinemia

Neovascular glaucoma is a rare and severe complication of hypoperfusion retinopathy.The appearance of hypoperfu- sion retinopathy complicating neovascular glaucoma in ophthalmolscopy and fundus fluorescein angiography shows a special feature. Neovascular glaucoma occurs when new fibrovascular tissues proliferate onto the chamber angle and obstruct the trabecular meshwork. The stenosis or occlusion of internal carotid artery is the most common reason of hypoperfusion retinopathy in elder people.Early recog- nition and treatment of patients with carotid occlusive diseases may prevent more serious complications.

Objective To compare the effectiveness and safety of different intracranial stents assisted coil embolization of intracranial aneurysms and to discuss the selection of different stent assisted embolization of intracranial aneurysm.Methods From 2007 April to 2012 April,118 cases (a total of 128 wide-neck aneurysms) with intracranial aneurysms were analyzed retrospectively.This included the use of 70 neuroform,38 Enterprise,and 20 Solitaire AB stents forthe treatment of intracranial aneurysms.The successful use,aneurysm occlusion at the immediate post-operation,and early period of peri-operative complications were recorded from those clinical data in order to assess the effectiveness and safety of the different intracranial stents,which assisted coil embolization of intracranial aneurysms.Rank sum test and x2 test were used for statistics.Results Three aneurysms assisted with Neuroform stent were planted unsuccessfully,and the Enterprise and Solitaire stents were placed successfully.The embolism results of three stents after immediate postoperative angiography aneurysm: Neuroform stent occlusion rate was 40.0％ (28/ 70),the tumor residual rate was 38.6 ％ (27/70),and the partial embolization rate was 21.4 ％ (15/70) ; The Enterprise stent occlusion rate was 42.1％ (16/38),the tumor residual rate was 36.8 ％ (14/38),and the partial embolization rate was 21.1％ (8/38).The Solitaire AB stent occlusion rate was 40.0 ％ (8/20),the tumor residual rate was 35.0 ％ (7/20),and the partial embolization rate was 25.0 ％ (5/20).There were not significant differences in aneurismal occlusion (H =0.12,P ＞ 0.05).Early peri-operative complications results were: Neuroform stent occurred in 7,Enterprise frame in 4,and Solitaire AB stent occurred in 2.There were no significant differences in the incidence of complications in the early period after coiling (x2 =0,P ＞ 0.05).Conclusions Three kinds of intracranial stents assisted embolization of intracranial aneurysms are applied safely and effectively.The stent may be chosen according to morphology of parent artery and stent biological character.

AIM: To observe the effects of vascular endothelial growth factor(VEGF) on the proliferation and differentiation of neural stem cells(NSCs) of rats in vitro.METHODS: NSCs isolated from the hippocampal gyrus of SD rats were primary cultured and subcultured,and then divided into two groups:(1) the cells in VEGF group were treated with 150 ?g/L VEGF in the culture system,and VEGF was removed at the 7 th day;(2) control group(without VEGF treatment).The cellular morphology of two groups was observed by contrast phase microscope.Nestin and NF-200 expressing cells were detected via immunofluorescence method.The percentages of the immunostaining positive cells in each group at the 7 th day and at the 11 th day were determined.RESULTS: At the 7 th day,the percentage of nestin positive cells in VEGF group was 52.19%?7.95%,vs 29.26%?4.12% in control group(P

Objective To study the impact of the off-pump coronary artery bypass compared to the on-pump coronary artery bypass technique on the rate of acute kidney injury.Methods A retrospective analysis of 824 patients accepted coronary artery bypass surgery in FuWai Hospital Surgical ICU from March 2011 to January 2013.Patients were divided into two groups according to the surgical approach,597 patients in on-pump group and 227 patients in off-pump group.Then compared the difference of acute kidney injury incidence in the two groups.Results 92 patients in the on-pump group occurred AKI,the incidence of AKI was 15.4％.32 patients in the off-pump group occurred AKI,the incidence of AKI was 14.1％.Two groups of patients had no statistical difference in the incidence of AKI,x2 =0.222,P =0.638.Based on the preoperative baseline creatinine clearance levels.We defined normal creatinine clearance (SCR ≥ 60 ml/min),mild renal insufficiency (45 ml/min ＜ SCR ＜60 ml/min),moderate renal dysfunction group(31 ml/min ＜ SCR ＜45 ml/min).Decline with the preoperative creatinine clearance rate,the AKI incidence was elevated significantly,P ＜0.05.Patients with moderate renal insufficiency,offpump patients had lower incidence of AKI than those in on-pump group,P ＜ 0.05.The incidence of renal replacement in the two group patients had no statistical differences.Conclusion The incidence of AKI after coronary artery bypass surgery had no statistical differences with or without pump.In the patients with preoperative moderate renal insufficiency,off-pump can reduce the incidence of AKI,but could not change the kidney the incidence of renal replacement treatment.

Study the serum level of HGF, Cys C and TGF-beta1 in type 2 diabetic nephropathy (DN), the infect of Pingshen decoction on those index. Selected 69 cases of 2 type DN and randomly divided into therapy group (36 cases) and control group (33 cases). The therapy group were treated with Pingshen decoction 1 dose/d, bid po. The control group were treated with NephritisShu tablet, 6 tablet, tid po. 8 weeks was a course. Before and after treatment, we examine the serum level of HGF, Cys C and TGF-beta1 by ELISA and immunonephelometry, and compare with 30 cases of healthy control group. The study demonstrates that before treatment, the serum level of HGF in both groups were significantly lower than healthy control group (P < 0.01), but Cys C, TGF-beta1 were significantly higher (P < 0.01). After treatment, the serum level of HGF of both groups were increased. The serum level of HGF of therapy group were significantly higher than of control group (P < 0.01), but the serum level of Cys C and TGF-beta1 were significantly lower than control group (P < 0.01). The serum level of HGF was correlated negatively with Cys C,TGF-beta1. In control group, the UAER, urine beta2-MG and quantity of 24-hour urine protein were significantly decreased after treatment (P < 0.01). The index of urine of therapy group were significantly lower than control group (P < 0.01). Results indicate that test of serum level of HGF and Cys C,TGF-beta1 of diabetic nephropathy have important clinical significance. Pingshen decoction can effectively intervene in the serum level of HGF and Cys C, TGF-beta1 and index of urine.
Aged ; Aged, 80 and over ; Case-Control Studies ; Cystatin C ; blood ; Diabetic Nephropathies ; blood ; drug therapy ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Hepatocyte Growth Factor ; blood ; Humans ; Male ; Middle Aged ; Transforming Growth Factor beta1 ; blood

Objective To report effects of microsurgical treatment for tumors in cervical spinal canal. Methods A total of 32 cases of tumors in cervical spinal canal had received microneurosurgery through a posternmedial approach. 22 cases had received reconstruction of cervical spinal canal stability. Results A total tumor resection was performed in 26 cases (81.25%),a subtotal tumor resection was conducted in 6 cases(18.75%). A cemplete recovery was achieved in 23 cases(71.88%), an improvement of symptoms was achieved in 6 cases(18.75%), and no improvement in 3 cases(9.38%), no death was encountered. Follow up observations were carded out in 30 cases for 3 months to 3 years. MRI examinatious 3 months after operation in 26 cases found no residual or recurrent tumor,recurrence was seen in 3cases of astrocytoma, 1 case was invariable. X-ray radiography in 26 cases showed good vertebral stability ,spinal deformation was found in 4 eases. Conclusion Microsurgery in early period play a key role in treatment of cervical spinal tumors. Reconstruction of spinal canal stability is important to patients.

Abstract: Objective　To investigate the pollution of paralytic shellfish poisons (PSP) in shellfish sold in Hainan Province from 2018 to 2021. Methods　From 2018 to 2021, the content of 10 paralytic shellfish poisons including saxitoxin (STX), neosaxitoxin (neoSTX), gonyautoxins 1 (GTX1), gonyautoxins 2 (GTX2), gonyautoxins 3 (GTX3), gonyautoxins 4 (GTX4), gonyautoxins 5 (GTX5), decarbamoylsaxitoxin (dcSTX), decarbamoylgonyau toxins 2 (dcGTX2) and decarbamoylgonyau toxins 3 (dcGTX3) in 7 kinds of shellfish commonly sold in 13 cities and counties in Hainan province was analyzed. Results　The detection rate of PSP in 360 shellfish samples was 10.3%. Among them, the highest detection rate of STX was 5.83%, followed by GTX2 detection rate of 4.17%; the detection rate of neoSTX and GTX3 were both 1.67%; the detection rate of GTX1 was 1.39%. None of the five PSP, GTX4, GTX5, dcSTX, dcGTX2 and dcGTX3, were detected. Four types of PSP were detected in fanscallops, two were detected in oysters, mussels and Scapharca subcrenata, only one was detected in scallops, and no toxin contamination was detected in clams and razor clams. A single sample of fanscallops detected a maximum of 4 PSP, and a single sample of oysters, scallops, mussels and Scapharca subcrenata detected a maximum of 1 PSP. The equivalence of PSP in all samples was ND-155.6 μg/kg.The annual detection rate of PSP from high to low was: 20.0% in 2020, 15.6% in 2019, 5.3% in 2018, and 2.0% in 2021, and none of the samples tested exceeded the standard. Continuously detectable STX in 2018-2020, all PSP that could be detected in 2018 were STX. In 2019, in addition to STX detected in scallops and Scapharca subcrenata, neoSTX was also detected in oysters, mussels and Scapharca subcrenata. In 2020, PSP was only detected from scallops, and GTX2 could be detected in all positive specimens, while 5 STX, 5 GTX1 and 6 GTX3 were detected. Only GTX2 detected from scallops in 2021. STX was detected in shellfish sold in 12 cities and counties, GTX2 can be detected in 10 cities and counties, neoSTX can be detected in 5 cities and counties, GTX1 and GTX2 were detected in 4 cities and counties respectively. Shellfish sold in Wenchang and Lingshui markets can detect 5 types of PSP. Conclusion　Some types of shellfish on the market in Hainan are contaminated with some kind of PSP pollution risks, and it is necessary to strengthen the supervision of PSP in marketed shellfish.

OBJECTIVETo explore clinical effects of suturing-assisted locking plate in treating elderly proximal humeral fractures.

METHODSFrom January 2005 to January 2013, 55 elderly patients with three- and four-part fractures of proximal humeral fractures were divided into treatment group and control group. In treatment group, there were 31 patients including 12 males, and 19 females aged from 65 to 85 with an average of (74.00±5.42) years old, and treated with suturing-assisted locking plates; 19 patients were Neer 3-part fractures, and 12 patients were Neer 4-part fractures of proximal humerus; 23 patients were suffered from low-energy injuries and 8 patients were caused by high-energy injuries. In control group, there were 24 patients including 7 males, and 17 females aged from 65 to 85 with an average of (72.79±5.34) years old, and treated with locking plates; 16 patients were Neer 3-part fractures, and 8 patients were Neer 4-part fractures of proximal humerus; 17 patients were suffered from low-energy injuries and 7 patients were caused by high-energy injuries. Operative time, blood loss during operation, and bone healing time between two groups were observed and compared. Postoperative Neer scoring were used to evaluate recovery of shoulder joint function.

RESULTSAll patients were followed up from 6 to 24 months with an average of 16.1 months. In treatment group, blood loss was (495.806±143.150) ml, function of Neer scoring was 22.645±2.443, range of action was 18.194±2.613, anatomy was 7.935±1.504 and total score of Neer scoring was 77.161±8.335; while in control group, blood loss was (641.667±169.851) ml, function of Neer scoring was 13.958±1.989, range of action was 13.083±2.165, anatomy was 5.500±1.978 and total score of Neer scoring was 58.792±7.313. There were sigificant difference between two groups in these indexes.

CONCLUSIONSuturing-assisted locking plate for the treatment of proximal humerus fractures in elderly, has advantages of less blood loss, simple fracture reduction and rapid recovery of shoulder joint, and is a effective method.

Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Humans ; Male ; Recovery of Function ; Shoulder Fractures ; physiopathology ; surgery ; Shoulder Joint ; physiopathology ; Sutures

Background/Aims: Endoscopic treatment (ET) has been applied for decades to treat subepithelial tumors, including gastrointestinal stromal tumors (GISTs). However, the efficacy of ET remains debatable. In this study, we evaluated the efficacy and safety of ET for GISTs in the upper gastrointestinal tract. Methods: This retrospective single-center study included 97 patients who underwent ET. All patients were enrolled from July 2014 to July 2018. Parameters such as demographics, size, resection margin, complications, pathological features, procedure time, total cost, and follow-up were investigated and analyzed. Results: Our study achieved 100% en bloc resection and 77.4% (72/93) R0 resection. The most common location was the fundus with a mean tumor size of 2.1±1.43 cm. The mean age, procedure time, hospital stay, and cost were 59.7±11.29 years, 64.7±35.23 minutes, 6.8 days, and 5,337 dollars, respectively. According to National Institutes of Health classification, 63 (64.9%), 26 (26.8%), 5 (5.2%), and 3 (3.1%) patients belonged to the very low, low, intermediate, and high risk classification, respectively. Immunohistochemistry results showed a 100% positive rate of CD34, DOG-1, CD117, and Ki67. A mean follow-up of 21.3±13.0 months showed no recurrence or metastasis. Conclusions ET is effective and safe for curative removal of GISTs in the upper gastrointestinal tract, and it can be a treatment of choice for patients with no metastasis.